Louisiana is ranked fourth highest in the country in obesity. Shockingly, 63 percent of the state's adults are obese or overweight, with one-third of children following in their footsteps. According to the Louisiana Council on Obesity Prevention and Management, the cost of child obesity-associated illnesses has soared from $35 million to $127 million in the past 20 years.

For the first time, Pennington Biomedical Research Center released Louisiana's Report Card on Physical Activity & Health for Children and Youth. The goal was to assess the data from across the state on physical activity and health outcomes for kids. This involved establishing a research advisory committee which examined all of the current epidemiologic evidence for Louisiana.

The report card graded the state for 12 different characteristics based on population surveys for children ages 5 to 18. Louisiana's overall grade this year was a disappointing D, which, unfortunately, was not unexpected by researchers. In the category of overweight and obesity, our children scored the lowest grade of F. "For the one indicator of obesity, we had to give a grade of F," said Peter T. Katzmarzyk, Ph.D., FASCM and associate executive director for population science at Pennington. "There was no way around that one."

According to Pennington's research, 36 percent of the state's children and youth are overweight or obese. More males exceed the weight threshold than females, and more African American kids exceed guidelines compared to whites and Hispanics. One of the key reasons is lack of physical activity.

For physical activity levels, Louisiana scored a D. Less than 30 percent of our children get vigorous physical activity daily. "Overall, the level of physical activity among Louisiana's children is quite low," Katzmarzyk observed.

Instead of playing outside as recommended, 53 percent of the state's youth spend more than two hours a day of screen time – that is, watching television or playing video games. The American Academy of Pediatrics recommends that children should watch no more than two hours of quality television programming a day. "Parents have to cut down on the time the children watch TV or sit in front of the computer or any activities similar to that," said Dr. Farooz Jalili, a pediatric gastroenterologist from Lafayette. "The children have to be involved in more outdoor activity."

Another troubling trend is that while 46 percent of high school students participate in physical education classes at school five days a week, the level of physical activity drops off quite dramatically from 9th to 12th grade — from 64 percent down to 26 percent. "So, not only are there low levels of activity, but also they tend to decline with age," Katzmarzyk said.

One observation was that activity varies according to socioeconomic status. More white youths play after-school sports than minorities. "For every indicator that we looked at, there were strong socioeconomic gradients, whereby those children who were better off in the population had lower levels of obesity and higher levels of physical activity," Katzmarzyk said. "And, as these kids were worse off in terms of socioeconomic status, those trends reversed."

The American Academy of Pediatrics recommends that kids should accumulate at least 60 minutes of age-appropriate physical activity over the course of a day. Jalili notes that the amount depends on the level of obesity, but that at least 20 minutes of activity a day, five days a week, is a start.

Whether rich or poor, the main objective in preventing obesity is to get children outside and away from the television or computer. This includes not only organized sports, but unstructured play. "We have lots of data now suggesting that kids who spend most of their time indoors are less active," Katzmarzyk said. "So, the thing is, we need to be getting our kids back outside and getting them active. We are trying to make this activity less regimented. We want to put active play back in every child's day – that's our slogan for this year – you want to get active play back into every kid's day."

While this year's study concentrated on activity, Pennington hopes to add information on diet to its report card for next year. In the past, Katzmarzyk said, people were focused on dieting to lose weight. But, the amount of physical activity is also very important. "If you are looking at obesity itself, it's a chronic condition that results from this energy imbalance over time, where you are taking in too many calories for the amount of activity you are doing," he explained. "So, activity is one key component to the energy balance equation. And, if you lead a physically active lifestyle, then the trends we see in diet may not impact your health to the same extent."

In his practice, Jalili sees an upswing in the amount of overweight and obese youngsters. He believes that inactivity and diet are the main problems. Complications which can result from obesity vary from emotional to severe physical problems. "There are medical complications, including elevation of blood pressure, elevation of blood sugar, as well as developing Type 2 diabetes," he explained. "The majority of these children have problems with the joints, which might not be able to handle such heavy weight and cause pain and, along with that, dislocated hips. They also may have difficulty breathing, particularly at night when they are asleep. And, if the blood pressure is not taken care of, and if the elevated cholesterol level is not addressed, then they will have cardiac problems as well."

Jalili says that part of the problem is that the family is not involved in the treatment of the child. "This is a family problem, it is not just the child's problem," he said.

He recommended that families of overweight and obese children participate in activities such as walking. Additionally, he said that parents must change their own dieting habits. "They cannot expect to have junk food at home and the kid not to eat it," he commented.

The Louisiana Obesity Council is trying to address the obesity problem by implementing programs in schools to teach kids to make healthy food choices and be physically active in order to prevent or reduce obesity. Initiatives include the School Wellness Policy Implementation Project, which will gather information from focus groups across the state to develop tools to advance the implementation of wellness policies in schools; 2008 Legislative Wellness Day, a collaborative effort between public and private sectors to increase the new administration's awareness of the importance of nutrition and physical activity to prevent and manage the obesity epidemic; Lighten Up Louisiana, a six-month physical activity challenge encouraging citizens to develop healthy exercise and eating habits; Louisiana 2 Step, a motivational program that teaches residents to eat right and move more, and the "Trim Kids" program developed at Louisiana State University for overweight kids, which is available at area YMCAs. For more information, visit LOC's website at www.dhh.louisiana.gov/offices/?ID=270.